Brown Recluse Spider Bites

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Cutaneous loxoscelism

Closets, attics, boxes, and basements are favorite urban settings for the brown recluse, or fiddle back spider. Deemed more of a public health menace than the black widow or any other arachnid, the brown recluse is surprisingly non-aggressive and won’t attack unless threatened.

At first, a person who has been bitten by a brown recluse may only notice irritation on the skin. After two to eight hours, the affected area becomes a papule. The papule turns white from the localized thrombosis, vasoconstriction and infarction of the tissue. After time, the skin lesion becomes more evident with the development of a hemorrhagic vesicle. The vesicle will subsequently rupture and form a black crust. As the crust sloughs, it has a necrotic ulcer that can extend through the subcutaneous fat and expose muscles and fascial planes. These disfiguring ulcers can be up to 25 cm.

Symptoms include fever, renal failure, chills, rash, nausea, and hemolytic anemia.

Hyperbaric oxygen therapy works to improve wound healing along with a course of antibiotics.

 

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